Estrogen-Progestagen Menopausal Hormone Therapy and Breast Cancer: Does Delay From Menopause Onset to Treatment Initiation Influence Risks?
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TLDR
It is suggested that, for some EP-MHT, the timing of treatment initiation transiently modulates the risk of breast cancer and that, when initiated close to menopause, even short durations of use are associated with an increased breast cancer risk.Abstract:
Purpose To investigate whether the relation between estrogen-progestagen menopausal hormone therapy (EP-MHT) and breast cancer risk varies according to the delay between menopause onset and treatment initiation. Participants and Methods Between 1992 and 2005, 1,726 invasive breast cancers were identified among 53,310 postmenopausal women from the French E3N cohort (mean duration of follow-up, 8.1 years). Hazard ratios (HRs) and CIs were estimated using Cox models, with MHT never users as the reference. Results Among recent users of EP-MHT, the risk of breast cancer varied according to the timing of treatment initiation. This variation was confined to short durations of use (≤ 2 years): the HR was 1.54 (95% CI, 1.28 to 1.86) for short treatments initiated in the 3-year period following menopause onset and 1.00 (95% CI, 0.68 to 1.47) for short treatments initiated later (P = .04 for homogeneity). However, this pattern of risks was not observed in users of EP-MHT containing progesterone, among whom there was...read more
Citations
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Journal ArticleDOI
The 2017 hormone therapy position statement of The North American Menopause Society.
JoAnn V. Pinkerton,Fernando Sánchez Aguirre,Jennifer Blake,Felicia Cosman,Howard N. Hodis,Susan Hoffstetter,Andrew M. Kaunitz,Sheryl A. Kingsberg,Pauline M. Maki,JoAnn E. Manson,Polly Marchbanks,Michael R. McClung,Lila E. Nachtigall,Lawrence M. Nelson,Diane Todd Pace,Robert L. Reid,Phillip M. Sarrel,Jan L. Shifren,Cynthia A. Stuenkel,Wulf H. Utian +19 more
TL;DR: Hormone therapy (HT) remains the most effective treatment for vasomotor symptoms and the genitourinary syndrome of menopause (GSM) and has been shown to prevent bone loss and fracture.
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The 2012 hormone therapy position statement of the North American Menopause Society
TL;DR: The more favorable benefit-risk ratio for ET allows more flexibility in extending the duration of use compared with EPT, where the earlier appearance of increased breast cancer risk precludes a recommendation for use beyond 3 to 5 years.
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Postmenopausal Hormone Therapy: An Endocrine Society Scientific Statement
Richard J. Santen,D. Craig Allred,Stacy P. Ardoin,David F. Archer,Norman F. Boyd,Glenn D. Braunstein,Henry G. Burger,Graham A. Colditz,Susan R. Davis,Marco Gambacciani,Barbara A. Gower,Victor W. Henderson,Wael N. Jarjour,Richard H. Karas,Michael Kleerekoper,Roger A. Lobo,JoAnn E. Manson,Jo Marsden,Kathryn A. Martin,Lisa W. Martin,JoAnn V. Pinkerton,David R. Rubinow,Helena J. Teede,Diane Thiboutot,Wulf H. Utian +24 more
TL;DR: A scholarly review of the published literature on menopausal hormonal therapy (MHT), make scientifically valid assessments of the available data, and grade the level of evidence available for each clinically important endpoint to arrive at major conclusions.
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Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial
Louise Lind Schierbeck,Lars Rejnmark,Charlotte Landbo Tofteng,Lis Stilgren,Pia Eiken,Leif Mosekilde,Lars Køber,Jens-Erik Beck Jensen +7 more
TL;DR: After 10 years of randomised treatment, women receiving hormone replacement therapy early after menopause had a significantly reduced risk of mortality, heart failure, or myocardial infarction, without any apparent increase in risk of cancer, venous thromboembolism, or stroke.
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Treatment of symptoms of the menopause: an Endocrine Society Clinical Practice Guideline
Cynthia A. Stuenkel,Cynthia A. Stuenkel,Susan R. Davis,Anne Gompel,Mary Ann Lumsden,Mary Ann Lumsden,M. Hassan Murad,JoAnn V. Pinkerton,JoAnn V. Pinkerton,Richard J. Santen,Richard J. Santen +10 more
TL;DR: Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms and other symptoms of the climacteric and benefits may exceed risks for the majority of symptomatic postmenopausal women who are under age 60 or under 10 years since the onset of menopause.
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